Wyant Woods Healthcare Center

Inspectors wroteTHE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY.Based on interview, record reviews, review of the facility self-reported incident (SRI), Board of Pharmacy documentation review, observation and facility policy review, the facility failed to protect Residents #101, #108, #111, #114, #115, #127, #219, #265, #400, and #401 from misappropriation of medications. This affected 10 (Residents #101, #108, #111, #114, #115, #127, #219, #265, #400, and #401) of 10 residents reviewed for misappropriation of medications. The facility census was 170.

Inspectors wroteBased on medical record review, observations, interview, manufacturers guidelines and policy review, the facility failed to sanitize blood glucose monitors appropriately. This affected one (Resident #243) of five residents who required blood glucose monitoring. The facility also failed to ensure infection control standards were followed when administering medications. This affected three (Residents #131, #199 and #218) of five residents observed for medication administration. This had the potential to affect all residents residing in the facility. The facility census was 170.

Inspectors wroteBased on record review, observation and interview, the facility failed to ensure adequate supervision and implement appropriate safety interventions for Resident #138, who continued to operate a power wheelchair at excessive speeds inside the facility despite multiple Occupational Therapy (OT) assessments identifying the resident as unsafe and recommending restriction of power wheelchair use to outdoor areas only. This affected one (Resident #138) of four residents reviewed for accidents. The facility census was 170.

Inspectors wroteBased on record review, observation, interview, manufactures guidelines and policy review, the facility failed to ensure Resident #218 rinsed his mouth after using a steroid inhaler. This affected one (Resident #218) of five residents observed for medication administration. The facility census was 170.

Inspectors wroteBased on record review, interview and policy review, the facility failed to administer Resident #402's medications within appropriate timeframes. This affected one (Resident #402) of five residents observed for medication administration. The facility census was 170.

Inspectors wroteBased on record reviews, interviews and facility policy review, the facility failed to ensure care plan meetings were offered timely to residents and guardians. This affected two residents (#117 and #134) out of three resident residents reviewed for care plan meetings. The facility census was 162.

Inspectors wroteBased on record review, interviews, laboratory test reviews, hospital medical records review, pharmacy reviews and facility policy review, the facility failed to ensure the monthly pharmacy reviews recommended Resident #117's seizure medications were monitored with laboratory tests timely to prevent high/critical/toxic levels. This affected one resident (#117) out of three residents reviewed for medication monitoring. The facility census was 162.

Inspectors wroteBased on record review, interviews and facility policy review, the facility failed to ensure Resident #117's antibiotic medication was administered according to the physician orders. This affected one resident (#117) out of four residents reviewed for medications. The facility census was 162.

Inspectors wroteBased on interview, record review and review of facility policies, the facility failed to ensure residents were appropriately supervised while smoking, resulting in an elopement. This affected one resident (#144) and had the potential to affect all 11 residents who smoked on the Hickory Unit (#24, #55, #75, #101, #102, #122, #129, #134, #144, #148 and #157). Facility census was 163.

Inspectors wroteBased on record review, observations and interviews, the facility failed to respond to or resolve concerns voiced by residents. This affected seven residents (#16, #21, #32, #42, #47, #56, and #112) of seven residents reviewed for Resident Council. The facility census was 158.

Inspectors wroteBased on observation, interview, record review, and review of facility policy, the failed to provide activities to meet the interest and needs of residents. This affected eleven residents (#16, # 21, #23, #24, #28, #32, #42, #47, #56, #62, and #112) of 30 residents observed for activities and had the potential to affect the 22 additional residents (#29, #73, #90, #103, #104, #107, #113, #114, #119, #120, #132, #136, #137, #138, #139, #142, #145, #150, #151, #152, #209, and #210) residing on the Birch unit. The facility census was 158.

Inspectors wroteBased on observations, interview, record review, and review of facility policy, the facility failed to ensure residents received proper assistance with personal hygiene and grooming tasks. This affected three residents (#25, #99, and #114) of five residents reviewed for activities of daily living. The census was 158.

Inspectors wroteBased on record review, observation and interview, the facility failed to maintain infection control standards during medication administration and failed to appropriately clean a glucometer. This affected one resident (#32) of four residents reviewed for medication administration. The facility identified 29 residents who required blood sugar monitoring. The facility census was 158.

Inspectors wroteTHE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Based on record review, review of the facility's self-reported incident (SRI) and associated facility investigation, review of police reports, review of facility policy, and interviews, the facility failed to prevent an incident of staff to resident abuse for Resident #78. This resulted in Immediate Jeopardy and actual physical and psychosocial harm on 09/19/24 when State Tested Nursing Assistant (STNA) #942 physically abused Resident #78 by spraying the resident in the face with oleoresin capsicum (OC) spray (also known as pepper spray). As a result, Resident #78 complained of his eyes burning and facility staff observed his eyes were red. [...]

Inspectors wroteBased on observation and interview, the facility failed to discard expired food items timely and appropriately label or date opened and prepared food items. This had the potential to affect all 166 of 167 resident who received food from the kitchen as Resident #151 received nothing by mouth (NPO). The facility census was 167.

Inspectors wroteBased on record review, review of the facility's self-reported incident (SRI) and associated facility investigation, review of facility policy, and staff interviews, the facility failed to remove a perpetrator of abuse from the facility immediately to ensure all residents were protected from further abuse. This affected one resident (#78) and had the potential to affect 22 additional residents (#61, #62, #63, #64, #65, #66, #67, #68, #69, #70, #71, #72, #73, #74, #75, #76, #77, #79, #80, #81, #82, and #83) who resided on the secured Hickory unit. The facility census was 167.

Inspectors wroteBased on record review, review of the facility's self-reported incident (SRI) and associated facility investigation, review of facility policy, and staff interviews, the facility failed to ensure staff reported allegations of abuse in a timely manner. This affected one resident (#78) of three reviewed for abuse. The facility census was 167.

Inspectors wroteBased on observation, record review and interview, the facility failed to appropriately assess and monitor Resident #80's closed reduction of the resident's left ankle fracture, a closed reduction of the resident's right first proximal phalanx fracture and a L1 inferior endplate fracture. This finding affected one (Resident #80) of three residents reviewed for quality of care.

Inspectors wroteBased on observation, interview, record review, and policy review the facility failed to maintain proper infection control techniques during wound care and insulin administration. This affected one (#40) of three residents observed for wound care, one (#165) of one resident observed for insulin administration, and had the potential to affected 52 residents (#2, #11, #12, #19, #21, #22, #26, #27, #35, #40, #46, #55, #56, #59,#62, #64, #69, #72, #73, #81, #83,#87, #91,#98, #102, #103, #106, #110, #111, #112, #115, #120, #122, #123, #126, #128, #129, #131, #134, #137, #140, #141, #142, #147, #149, #151, #153, #156, #157, #165 #166 and #169) residing on the Oak and Walnut halls where Registered Nurses #427 and 304 were providing care. The facility census was 170.

Inspectors wroteBased on observation, interview, record review, and policy review the facility failed to ensure Resident #165's diabetes was managed appropriately by ensuring insulin was administered according to physician orders. This affected one (#165) of four residents observed for medication administration. The facility census was 170.

Inspectors wroteBased on record review, self-reported incident (SRI) review, review of a police report, personnel file review, facility policy review and interviews, the facility failed to ensure Resident #161 was free from staff to resident physical abuse. This resulted in Immediate Jeopardy, the potential for actual physical harm and actual psychosocial harm on 07/24/24 at approximately 10:40 A.M. when Activity Aide (AA) #307 physically abused Resident #161 by jumping on and punching the resident after the resident hit AA #307 with his cane. Staff in the area told AA #307 to back away from Resident #161 but she did not. AA #307 then had to be restrained by Maintenance Technician (MT) #438 as she continued to kick and further assault Resident #161. Interview with Resident #161 on 07/30/24 at 4:18 P.M. revealed he did not feel safe at the facility due to the incident. [...]

Inspectors wroteBased on observations, record review, facility investigation review, police report review, facility policy review, review of weather information from www.wunderground.com and interviews, the facility failed to maintain a safe environment and provide necessary supervision to prevent Resident #158, who had diagnoses including schizoaffective disorder, auditory hallucinations, dementia with other behavioral disturbance, homicidal ideations and delusional disorder from eloping from the facility. This resulted Immediate Jeopardy and the potential for actual harm on 07/14/24 when Resident #158 exited the facility without staff knowledge after State Tested Nursing Assistant (STNA) #356 propped the back (locked) door of the secured Buckeye unit open with a wet floor sign. [...]

Inspectors wroteBased on personnel file review, interview and review of the facility policy, the facility failed to hire staff free of disqualifying offenses including abuse. This affected three out of five personnel files reviewed and had the potential to affect all 161 residents in the facility.

Inspectors wroteBased on personnel record review, facility policy review, and interview, the facility failed to implement their abuse policy and procedure regarding checking potential applicants against the Ohio Nurse Aide Registry (NAR). This affected three out of five personnel files reviewed and had the potential to affect all 161 residents who resided in the facility.

Inspectors wroteBased on medical record review, review of admission documents, staff interviews, and review of facility policy, the facility failed to timely implement effective and individualized interventions to address behavioral health concerns. In addition, the facility failed to monitor the effectiveness of interventions once implemented. This affected one (#70) of three residents reviewed for behavioral health services. The facility census was 167.

Inspectors wroteBased on record review of the Payroll Based- Journal (PBJ) Staffing Data Report and staff interview, the facility failed ot meet the required minimum staffing levels to meet the needs of the residents. This had the potential to affect all 163 residents residing at the facility. The facility census was 163.

Inspectors wroteBased on observation of a video recording, resident interview, staff interview, medical record review, self-reported incident (SRI) review, and policy review, the facility failed to ensure a resident's privacy was maintained, when the resident was video recorded without their permission. During the recording, a staff member was questioning the resident about their opinion on body piercing's. Subsequently the video was posted to a social media website with laughing emojis (small digital image or icon used to express an idea, emotion, etc.) at the bottom of the video. This affected one (#4) of three resident reviewed for privacy. The facility census was 163.

Inspectors wroteBased on medical record review, observation and staff interview, the facility failed to ensure fall prevention interventions were in place as ordered by the physician and per the fall plan of care. This affected two (Residents #15 and #62) of three residents reviewed for falls. The facility census was 164.

Inspectors wroteBased on record review and interview, the facility failed to conduct a thorough investigations when investigating a self-reported incident (SRI) for Resident #7, #53, and #409 and when investigating an injury of unknown origin for Resident #33. This affected four residents (Resident #7, #33, #53, and #409) out of five residents reviewed for abuse.

Inspectors wroteBased on observation, interview, and record review, the facility failed to residents were supervised during smoking. This affected eight residents (Resident #30, #35, #36, #54, #70, #80, #129, and #133) of nine residents reviewed for smoking.

Inspectors wroteBased on observation, interview, facility policy review and record review, the facility failed to ensure oxygen tubing was dated to ensure timely replacement. This affected eight residents (Residents #23, #44, #61, #69, #96, #118, #138 and #145) of 15 residents utilizing oxygen therapy.

Inspectors wroteBased on observation, interview and menu spreadsheet review, the facility failed to follow the menu as written. This affected three residents (Residents #38, #95 and #459) observed out of eight residents receiving pureed meals.

Inspectors wroteBased on observation, interview and recipe review, the facility failed to ensure pureed foods were prepared in an appropriate manner that preserved its nutritional value. This affected eight residents (Residents #23, #38, #45, #95, #108, #123, #154 and #459) receiving a pureed diet.

Inspectors wroteBased on observation, interview, policy review, record review and guidance from the Centers for Disease Control and Prevention (CDC), the facility failed to ensure staff wore appropriate personal protective equipment (PPE) to prevent the further spread of COVID-19. This had the potential to affect all 16 residents (Residents #27, #29, #31, #38, #42, #59, #62, #66, #69, #90, #95, #105, #107, #120, #122 and #138) residing on the [NAME] unit. The facility census was 153 residents.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure residents were treated with dignity and respect at all times. This affected three residents (Resident #3, #9, and #23) of 42 reviewed for dignity.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure call lights were in reach. The affected two residents (Resident #19 and Resident #37) out of nine residents reviewed for accommodation of needs.

Inspectors wroteBased on record review and interview, the facility failed to ensure resident funds were disbursed in a timely manner for Resident #209 after death as required. This affected one resident (Resident #209) of five residents reviewed for resident funds.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide shaving assistance to Resident #50 and nail care to Resident #103 timely. This affected two residents (Residents #50 and #103) of four residents reviewed for activities of daily living (ADL).

Inspectors wroteBased on observation, interview, and record review, the facility failed to change a unsecured sterile dressing utilized to prevent infection at a peripherally inserted central catheter (PICC) line site for Resident #53. This affected one resident (Resident #53) of one resident reviewed for care of PICC line dressings.

Inspectors wroteBased on record review and interview, the facility failed to ensure Resident #94's restorative program and splint devices were implemented to assist with range of motion. This affected one resident (Residents #94) of three reviewed for restorative services.

Inspectors wroteBased on record review and interview, the facility failed to ensure Resident #9 urine and bowel restorative program was implemented as ordered. This affected one resident (Resident #9) of three reviewed for restorative services.

Inspectors wroteBased on interview and record review, the facility failed to recognize and address Residents #3, #140, and #459's significant weight loss. This affected three residents (Resident #3, #140, and #459) of eight residents reviewed for weight loss.

Inspectors wroteBased on observation, interview, and record review, the facility failed to change a unsecured sterile dressing utilized to prevent infection at a peripherally inserted central catheter (PICC) line site for Resident #53. This affected one resident (Resident #53) of one resident reviewed for care of PICC line dressings.

Inspectors wroteBased on observation, interview, and record review, the facility failed to assure staff were trained and competent on assessment and monitoring of a peripherally inserted central catheter (PICC) line dressings to assure the insertion site was secure and not left exposed. This affected one resident (Resident #53) of one resident reviewed for care of PICC line dressings.

Inspectors wroteBased on observation, interview and record review, the facility failed to provide foods per preference. This affected one resident (Resident #62) of four residents reviewed for dietary preferences.

Inspectors wroteBased on record review and interview, the facility failed to ensure the resident's medical record was complete and accurate. This affected one (Resident #156) of one resident reviewed for discharge records.

Inspectors wroteBased on observation and interview, the facility failed to ensure soiled linens were handled to prevent cross contamination during transport and failed to ensure the bottled hand sanitizers used on medication carts were alcohol based. This had the potential to affect all residents residing in the facility. The facility census was 167.

Inspectors wroteBased on observation and staff interview the facility failed to maintain a clean and sanitary environment for its residents. This affected Residents #71, #164, #121, #5, #49, #2, #13, #14, #36, #57, #133, #139, #141, #260, #99, #150, #111, #136, #106, #155, #156, #35, #47, #22, #44, #154, #61, #108, #129, #107, #151, #3, #24, #189 and had the potential to affect all residents. The facility census was 167.

Inspectors wroteBased on observation and interview the facility failed to ensure the dining tables on the hickory unit were structurally sound and stable for residents to eat their meals from. This affected four of 19 residents who ate their meals in the Hickory unit, Residents #44, #101, #157, and #365. The facility census was 167.

Inspectors wroteBased on record review and interview, the facility failed to ensure Resident #156's advance directives and physician orders accurately reflected the resident's code status. This affected one (Resident #156) of thirty-two residents whose records were reviewed.

Inspectors wroteBased on observation, record review and interview, the facility failed to timely assess bruising and immediately report the bruising as an injury of unknown origin to the State Agency. This affected one (Resident #122) of four residents reviewed for general skin conditions.

Inspectors wroteBased on record review and interview, the facility failed to ensure Residents #24 and #146 and their representatives were notified in writing the reason for the discharge to the hospital in an easily understood language. This affected two (Residents #24 and #146) of five residents whose records were reviewed for hospitalization.

Inspectors wroteBased on record review and interview, the facility failed to ensure Residents #24 and #146 and their representatives were notified in writing of the facility policy for bed holds including the reserve bed payment. This affected two (Residents #24 and #146) of five residents whose records were reviewed for hospitalization.

Inspectors wroteBased on record review and interview, the facility failed to ensure Residents #24 and #128's activity care plans included measurable goals and interventions to meet the physical, mental and psychosocial well-being of the residents. This affected two (Residents #24 and #128) of 38 residents whose care plans were reviewed.

Inspectors wroteBased on record review and interview, the facility failed to ensure Resident #24's skin care plan was revised to include goals and interventions related to the resident's left hand cast. This affected one (Residents #24) of 38 residents whose care plans were reviewed.

Inspectors wroteBased on record review and interview the facility failed to ensure the restorative program for ambulation was provided for Resident #97 and restorative program for range of motion was provided for Resident #23. This affected two out of three residents reviewed for restorative programs.

Inspectors wroteBased on observation, record review and interview the facility failed to ensure Resident #160's fingernails were clean and manicured and Residents #38 and #160's faces were free of excessive facial hair. This affected two (Residents #38 and #160) of 35 residents observed for activities of daily living.

Inspectors wroteBased on interview and record review the facility failed to ensure accurate weights were obtained and to verify weights as needed. This affected two residents (Residents #49 and #63) of nine residents reviewed for nutrition. The facility census was 167.

Inspectors wroteBased on observation, record review and interview the facility failed to ensure Resident #55's enteral feedings infused as ordered by the physician. This affected one (Resident #55) of one resident receiving tube feeding in the facility.

Inspectors wroteBased on record review, observation, and interview the facility did not ensure Resident #122's medical record included documentation of two separate resident to resident incidents including assessments and interventions which were completed following the incidents. This affected one (Resident #122) of 39 residents whose records were reviewed.